AB0305 HOW DOES PSYCHOLOGICAL TRAUMA AFFECT THE COURSE OF RHEUMATOID ARTHRITIS?
Authors: A. Nurmamedov, S. Lezhenina, N. Shuvalova, E. Guryanova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Psychological trauma is a short-term or long-term stressful event associated with a sense of extreme threat or catastrophe. Psychological trauma predisposes to the development of a systemic inflammatory process. Dysregulation of the immune response occurs, which leads to an increase in the rate of aging of immune cells and changes in gene expression in immune cells, contributing to the development of autoimmune aggression [1]. The effect of psychic trauma on the decrease in IL-6 promoter methylation in patients with rheumatoid arthritis was revealed [2]. <h3>Objectives</h3> The purpose of the study: to evaluate the impact of psychological mental trauma on the course of rheumatoid arthritis. <h3>Methods</h3> The study was conducted from September 2021 to September 2022. 80 patients with RA of varying severity were examined. Inclusion criterion was a European Antirheumatic League diagnosis of RA (EULAR/ACR 2010). The age of the patients ranged from 20 to 69 years. (Mean age of patients was 48 +/- 6.24). Most of the examined women - 85%. The study was carried out in two stages. The first stage is (screening). All patients admitted to the hospital were determined the level of situational and personal anxiety according to the Spielberger questionnaire modified by Yu.L. Khanina. The results obtained were interpreted: up to 30 points - a low level of anxiety, 31-45 points corresponded to the average level, over 45 points - a high level of anxiety. At the second stage (39 patients with medium and high levels of situational and/or personal anxiety), a survey was conducted, consisting of two blocks. The first block revealed the psychotraumatic factor by groups. 1. Shock injuries (a situation that threatens a person's life, various types of violence). 2. Injuries of loss (loss of a loved one, job, property). 3. Relationship trauma (betrayal, family relationship discomfort). 4. Others. The second set of questions assessed the relationship between the course of RA and psychic trauma, especially the onset of the disease. Statistical processing of the results was carried out in MS Office Excel programs. <h3>Results</h3> Almost half of 39 (48.7%) patients entered the second stage of the study, i.e. they had an average or high level of situational and/or personal anxiety. Shock injury was observed in 3 (3.75%) patients, loss trauma in 5 (6.72%) patients, relationship trauma in 29 (36.25%) patients, other causes indicated in 2 (2.5%) patients Acute trauma was detected in 5 (6.25%) patients, chronic trauma in 32 (40%) patients, 2 (2.5%) patients found it difficult to answer. In the analysis of the second block of questions of the questionnaire, 31 (38.75%) patients note the relationship between PT and worsening of the course of RA. Deterioration in the form of increased pain syndrome was noted by 37 (46.25%) patients, an increase in edema of the affected joints was noted by 30 (37.5%) patients, a decrease in mobility in the joints was noted by 26 (32.5%) patients. Most of the 36 patients note that about 2 months passed from the moment of PT to the worsening of the course of RA. In 2.5% of patients, the onset of RA disease with a history of acute PT was observed. <h3>Conclusion</h3> Psychological trauma worsens the course of RA. This deterioration manifests itself in the form of an increase in pain, an increase in swelling of the affected joints, and a decrease in joint mobility. In the treatment of patients with RA, it is necessary to use a multidisciplinary approach involving psychologists and psychotherapists in order to timely identify and treat psychological trauma. <h3>References</h3> [1] Hakamata Y, Suzuki Y, Kobashikawa H, Hori H. Neurobiology of early life adversity: A systematic review of meta-analyses towards an integrative account of its neurobiological trajectories to mental disorders. Front Neuroendocrinol. 2022;65:100994. doi:10.1016/j.yfrne.2022.100994 [2] Danese A, J Lewis S. Psychoneuroimmunology of early-life stress: The hidden wounds of childhood trauma? neuropsychopharmacology. 2017;42(1):99-114. doi: 10.1038/npp.2016.198 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.